Kornimate/medical-research-clean huggingface dataset:
diagnosis of tuberculosis in swiss children

Conditions: Tuberculosis; Mycobacterium Tuberculosis

Summary: 1. the primary objective is to improve the sensitivity of novel immunodiagnostic tests for detection of tb disease in children. 2. the secondary objective is to determine biomarkers that discriminate children with tb infection and disease.

1. this will be done by measuring a variety of parameters in the blood samples and compare them with the current diagnostic gold standard for tb or for culture/naat non-confirmed tb cases a consensus case definition is used. currently available immunodiagnostic tests (igra/tst) will be compared to novel immunodiagnostic tests which will include: * several novel, additional m. tuberculosis-specific antigens * cytokines that are highly expressed 2. since there is no diagnostic gold standard for tb infection we will rely on a clinical composite reference standard for diagnosing tb infection. biomarkers will be determined by: * including m. tuberculosis-specific antigens that are specifically expressed in either tb infection or disease, * measuring phenotypes and cytokine production of m. tuberculosis-specific cells. * performing nmr analysis with biofluids in order to identify metabolomic signatures in patients with tb disease and tb infection

Eligibility criteria:
inclusion criteria: * all children / adolescents \< 18 years of age undergoing evaluation for tb exposure, infection or disease. exclusion criteria: * children / adolescents with tb infection or disease who have already been started on anti-mycobacterial treatment, children who have been treated for tb previously.

Keywords: immunodiagnostics tests tb exposure latent tb tb disease biomarkers metabolomics nmr
comparison of an office-based limited facelift and hospital-based full facelift

Conditions: Skin Aging; Facial Asymmetry; Aging Problems

Summary: to compare safety, patient satisfaction, and technical correction between a limited and full facelift, patients meeting strict clinical and safety criteria for both types of facelift will be randomly assigned to have one of these procedures. in the context of this study, a limited facelift is done in the office under local anesthesia, and a full facelift is done in the hospital or ambulatory surgical center with either general anesthesia or intravenous sedation.

while there are previous reports of facelift in an office-based setting without general anesthesia or intravenous sedation, these reports included patient demographic information, medical history, and complication rates only and did not compare their office-based facelift with a full facelift done in the hospital or ambulatory surgical center. previous reports also included oral sedation for all patients. the current study will address these gaps in what is known about office-based limited facelifts done with local anesthesia. finally, the study will also ascertain patient satisfaction at 3 points-at the pre-operative visit, early post-operative visit, and final visit-using selected modules from the validated face-q \| aesthetics survey.

Eligibility criteria:
inclusion criteria: * patient willing to randomly undergo either a limited facelift done in the office or a full facelift done in the hospital * patient willing and able to accept financial responsibilities of undergoing either type of facelift. * patient able to provide informed consent * between age 40-years-old and 85-years-old * no history of bleeding disorder * bmi \<25 * stable weight * does not have implanted cardiac device * minimal anxiety * no history of smoking * stable, good health * normal blood pressure or well-controlled hypertension * surgeon believes patient could tolerate and safely undergo either a limited facelift done in the office or a full facelift done in the hospital exclusion criteria: * patient refusal to randomly undergo either a limited facelift done in the office or a full facelift done in the hospital * patient not willing or not able to accept financial responsibilities of undergoing either type of facelift. * patient unable to provide informed consent * under age 40-years-old or over 85-years-old * history of bleeding disorder * bmi \>25 * unstable weight * has implanted cardiac device * significant anxiety * history of smoking * significant active disease (e.g., dementia, cancer, chronic respiratory illness, heart disease, etc.) * uncontrolled hypertension * surgeon believes patient could not tolerate or safely undergo either a limited facelift done in the office or a full facelift done in the hospital

Keywords: rhytidoplasty facelift rhytidectomy superficial musculoaponeurotic system
left atrial appendage closure registry of henri mondor hospital

Conditions: Atrial Fibrillation

Summary: intro: patients with atrial fibrillation are at significant risk of thrombus formation in the left atrial appendage, which can lead to strokes or systemic embolisms. this risk justifies first-line prescribing of long-term oral anticoagulant therapy in these patients. percutaneous left atrial appendage closure, is an interventional cardiology technique for patients at high risk of stroke related to atrial fibrillation in whom long term anticoagulation therapy cannot be conducted. this procedure involves implantation of an occlusion device into the left atrial appendage to close it and prevent migration of thrombotic material that could otherwise cause distant embolism. closure of the left atrial appendage avoids long-term prescription of anticoagulants while protecting patients against the risk of systemic embolism and stroke. hypothesis/objective: the main objective of this study is to assess the long term efficacy of left atrial closure, 5 years after the procedure method: 150 patients will be included prospectively. we will also include restropectively100 other patients, previously treated by left atrial appendage closure at henri mondor hospital. demographic, clinical, echocardiographic, and computed tomography data will be obtained by physical examination or medical records. conclusion: this study will allow to assess the long term efficacy of left atrial closure in atrial fibrillation patients.


Eligibility criteria:
inclusion criteria: * any patient for whom an indication has been made for implantation of a device for the closure of the left atrial appendage without restriction of indication and regardless of the outcome of the procedure (implantation success or not) exclusion criteria: * refusal of the patient to participate in this study * minor patient * patient not affiliated to the french social security system

Keywords: atrial fibrillation, left atrial appendage closure, stroke, anticoagulation, bleeding
tap block with plain bupivacaine versus wound infiltration with exparel for postoperative pain management

Conditions: Postoperative Pain

Summary: in this randomized, controlled, observer-blinded study we plan to evaluate pain relief after ultrasound-guided transversus abdominis plane (tap) block using bupivacaine and wound infiltration using liposomal bupivacaine in patients undergoing abdominal hysterectomy.

patients undergoing open total abdominal hysterectomy at parkland hospital (n=60) will be randomized into one of two groups to receive either ultrasound-guided bilateral tap block with bupivacaine (group 1) or infiltration of the surgical wound with liposomal bupivacaine (group 2) for postoperative pain management. the remaining aspect of perioperative care, including the general anesthetic technique, postoperative care will be standardized and will be similar for all patients. the duration of the involvement in the study will be until 48 hours postoperatively. the pre-anesthesia care unit personnel will identify patients during their preoperative clinic visit. patients in group 1 will receive ultrasound-guided bilateral tap block at the end of the surgery. patients in group 2 will receive exparel prior to closing the incision which will be injected subfascially and subcutaneously. in the first 24-h postoperative period, patients in both groups will receive acetaminophen 1000 mg every 6 h orally, ketorolac 30 mg, iv every 6 h, orally and morphine via an intravenous patient controlled analgesia (iv-pca) system to maintain adequate pain control. in the 24-48 h study period, all patients will receive oral ibuprofen 800 mg and acetaminophen 1000 mg three times a day and a combination of hydrocodone/acetaminophen 5mg/ 325 mg 1-2 tablets, as needed. the postoperative analgesia will be documented using the visual analog score (0=no pain, 10=worst pain). in addition, total opioid dose over the 48-h study period will be documented. postoperative nausea will be measured using a categorical scoring system (none=0, mild=1, moderate=2, severe=3) and episodes of vomiting will be documented. rescue antiemetics will be given to any patient who complains of nausea and/or vomiting. all variables will be assessed at 2, 6, 12, 24, and 48 hours, postoperatively by an investigator blinded to group allocation.

Eligibility criteria:
inclusion criteria: * female * asa physical status 1-3 * scheduled for open abdominal hysterectomy * age 18-80 years old * able to participate personally or by legal representative in informed consent in english or spanish exclusion criteria: * history of relevant drug allergy * age less than 18 or greater than 80 years * chronic opioid use or drug abuse * significant psychiatric disturbance * inability to understand the study protocol * refusal to provide written consent

Keywords: pain, liposomal bupivacaine, wound infiltration
impact of burden in caregivers of patients hospitalized for a psychotic episode: a multicenter study

Conditions: The Objective of Our Study is to Assess and Take Into Account Early on the Suffering of Family Members

Summary: family support is a positive predictor for psychiatric patients. for example, since the 1980s, it has been shown that family psychoeducation improves patient adherence to care and statistically decreases patient relapse and hospitalization rates by half, resulting in lower care costs. yet, the stress of hospitalizing a patient, seeing the feelings of shame or guilt of caregiver and the impact on their quality of life are rarely taken into account by caregivers during the first weeks hospitalization in a patient's psychiatry. barrelet emphasizes the importance of organizing the meeting in the first hours of hospitalization with the family in order to strengthen the alliance, to improve communication.


Eligibility criteria:
inclusion criteria: * family members or relatives * over 18 years * having a relative * first hospitalized in psychiatry or hospitalized in psychiatry within 5 years * over 18 years of age * psychotic episode * having been informed of their participation in this study * in regular contact with the patient prior to hospitalization, at least 4 hours per week. * french language * signed written informed consent. exclusion criteria: -psychiatric pathology of another family member than the hospitalized.

Keywords: psychiatry nurse burden caregiver
mri outcomes of mindfulness meditation for migraine

Conditions: Migraine

Summary: 112 migraine subjects will be initially randomly assigned to mindfulness-based stress reduction (mbsr) or a stress management for headache group (smh). outcomes, including headache frequency and impact and brain activity, will be assessed at baseline, prior to intervention, and at 3-, 6-, and 12-months.

subjects in the mbsr group undergo a standardized 8-week mbsr course plus an additional 4 sessions over another 8 weeks that further emphasize and train subjects on mbsr concepts and skills. the smh group will have 12 sessions spread out in a similar fashion to mbsr. clinical outcomes are compared between groups at 3, 6, and 12 months to assess efficacy of mbsr. mri scans are performed at baseline, 3 months, and 6 months changes in mri metrics after mbsr and changes in mri metrics associated with long-term mbsr practice. 30 healthy controls will also undergo mri scanning to determine abnormal brain activity and structure in migraineurs compared to healthy controls across the 6 month period of observation.

Eligibility criteria:
inclusion criteria * are between 18 and 65 years of age * report between 4 and 14 headaches over 28 days * have a history of migraines lasting at least 1 year * are not currently using opioid ("narcotic") pain medication exclusion criteria * are unable to undergo mri * pregnant, lactating, or planning to become pregnant * current use of opioid medications inclusion criteria for healthy volunteers (same exclusion criteria) * are between 18 and 65 years of age * free of any acute or chronic pain condition and reports no history of migraines

Keywords: migraine headache meditation mindfulness based stress reduction mbsr
"smart family doctor" assisted comprehensive management of secondary prevention among post coronary artery bypass graft patients

Conditions: Post Coronary Artery Bypass Grafting; Hypertension; Diabetes Mellitus; Hyperlipidemia

Summary: this study aims to evaluate the effect of an ai-assisted "smart family doctor" digital health management tool on improving the control rates of hypertension, diabetes, and dyslipidemia in post-cabg (coronary artery bypass grafting) patients. a randomized controlled trial design will be used, involving approximately 5-10 hospitals and 536 participants. eligible participants are adults aged 18 or older, post-cabg patients with hypertension, diabetes, and dyslipidemia.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years. * history of cabg surgery with history of hypertension, diabetes, and dyslipidemia. * at least one of the following criteria is meet: * systolic blood pressure no less than 130 mmhg or diastolic blood pressure no less than 80 mmhg * hba1c no less than 7% * ldl-c no less than 1.8 mmol/l * use of a smartphone. * signed informed consent. exclusion criteria: * history of heart failure or severe arrhythmias. * presence of other severe underlying conditions such as cancer or liver and kidney insufficiency. * pregnancy, lactation, or plans for pregnancy within the next year. * cognitive, communication impairments, or limitations in daily activities.

Keywords: smartphone ai-assisted cabg management metabolic management smart family doctor
efficacy and safety comparison of metformin/glimepiride combination versus each compound alone in new diagnosed type 2 diabetes patients

Conditions: Diabetes Mellitus, Type 2

Summary: primary objective: - to demonstrate the superiority of glimepiride and metformin free combination in comparison to glimepiride or metformin alone in terms of hb1ac reduction during a 24-week treatment period in patients with type 2 diabetes mellitus. secondary objectives: - to assess the effects of the free combination of glimepiride and metformin in comparison to glimepiride or metformin alone on: * percentage of patients reaching hba1c \< 7% * percentage of patients reaching hba1c \< 6.5% * fasting plasma glucose (fpg) * safety and tolerability

the study duration for each patient is approximately 27 weeks with 3 periods: 2-week screening period followed by 24-week treatment period where patient is assigned to one of the three arms according to randomization, and 3 days follow-up period with a last call phone visit.

Eligibility criteria:
inclusion criteria * patients with type 2 diabetes mellitus, as defined by the world health organization (who), diagnosed within one year prior to the screening visit * signed informed consent, obtained prior to any study procedure exclusion criteria * age \ 78 years old * hba1c \ 9% * bmi \> 35 kg/m2 * diabetes other than type 2 diabetes (e.g.: type 1 diabetes, diabetes secondary to pancreatic disorders, drug or chemical agent intake...) * subjects currently receiving or who have received any hypoglycemic agent within 3 months before screening visit the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
mitigating burnout in nursing and associated healthcare staff

Conditions: Burn Out; Nurses

Summary: workplace stress for healthcare workers is at an all-time high and the covid-19 pandemic magnified and amplified the impact of stress and burnout on health care workers, especially for frontline staff such as nurses. there are multiple external and individual factors that affect clinician well-being, and organizational factors are an important aspect to address when attempting to mitigate nurse burnout and improve well-being. this project seeks to expand two interventions that were piloted in the last few years since the covid-19 pandemic, validated to show improvement in staff well-being and decreased feelings of burnout following the interventions, and are easily implemented to benefit nurses and other multidisciplinary health care workers and students in both the inpatient and outpatient settings.


Eligibility criteria:
inclusion criteria: - english-speaking employees or students at penn state health and college of medicine. exclusion criteria: - non-english speaking individuals

Keywords: burnout nurses music therapy
chronic hemodialysis without systemic heparinization : a randomized study

Conditions: Contra-Indication to the Use of Low Molecular Weight Heparin

Summary: conventional hemodialysis requires transient systemic anticoagulation to prevent blot clotting after contact with the extracorporeal circuit. however, low molecular weight heparin (lmwh) or unfractioned heparin are contra-indicated in dialysis patients at risk for hemorrhagic complications. in this setting, several procedures theoretically allow dialysis without systemic heparinization, but randomized studies to compare them are lacking. the gold standard is the use of iterative rises of the extra corporeal circuit with isotonic saline (" rises "). two emerging procedures are increasingly used : continuous pre-dilution of the arterial line (" pre-dilution ") and the use of a specific dialysis membrane (nephral 400 st) coated with heparin immediately before use (" heparin adsorption ").

conventional hemodialysis requires transient systemic anticoagulation to prevent blot clotting after contact with the extracorporeal circuit. however, low molecular weight heparin (lmwh) or unfractioned heparin are contra-indicated in dialysis patients at risk for hemorrhagic complications. in this setting, several procedures theoretically allow dialysis without systemic heparinization, but randomized studies to compare them are lacking. the gold standard is the use of iterative rises of the extra corporeal circuit with isotonic saline (" rises "). two emerging procedures are increasingly used : continuous pre-dilution of the arterial line (" pre-dilution ") and the use of a specific dialysis membrane (nephral 400 st) coated with heparin immediately before use (" heparin adsorption "). we propose a monocentric prospective randomized open study to compare " rises ", " pre-dilution " and " heparin adsorption " in chronic hemodialysis patients with contra-indication to the use of lmwh. main criteria will be extra-corporeal circuit clotting, with dialysis efficiency and tolerance as secondary criteria. comparison will be made on grounds of " n-of-1 " trial, i.e. series of randomized cross-over tests in individuals. we have planned to include 75 patients in this study, with 1050 lmwh-free dialysis sessions. we hope to demonstrate chat by comparison wit rises, pre-dilution and heparin absorption techniques reduce the rate of extra-corporeal circuit by 30 and 50% respectively. we also hope to show that heparin adsorption (i) better preserves membrane integrity throughout the dialysis session, resulting in enhanced dialysis efficiency ; (ii) avoids extra fluid infusion and ultrafiltration, resulting in better dry weigh achievement and better clinical tolerance.

Eligibility criteria:
inclusion criteria: * chronic hemodialysis patient * low molecular weight heparin contra indicated for at least 3 consecutive hemodialysis sessions. exclusion criteria: * acute renal failure * access flow \< 250 ml/mn) * per dialytic blood transfusion or parenteral nutritional support * systolic bp \< 80 mm hg * hemoglobin \> 13 g/dl

Keywords: hemodialysis heparin clotting
thromboelastography to study burn coagulopathy

Conditions: Burn; Coagulation, Blood

Summary: this pilot study examines the use of thromboelastography (teg), a specialized blood test, to evaluate clotting abnormalities in burn patients. the study aims to understand how burn injuries impact the body's ability to form and break down blood clots over time. specifically, the investigators will research whether the percentage of total body surface area burned (%tbsa) is associated with changes in blood clotting, track the evolution of clotting patterns during the first four weeks following a burn injury, and explore whether these changes can predict recovery or complications. by providing new insights into clotting dynamics in burn patients, the study seeks to improve diagnostic methods, enhance monitoring strategies, and guide treatments to optimize patient care and outcomes.


Eligibility criteria:
inclusion criteria: * patients admitted with acute burn injuries * aged 18 years and older * provided consent to participate in the study exclusion criteria: * patients with a history of venous thromboembolism or hyper/hypocoagulopathy

Keywords: burn coagulation thromboelastography
genoa oral growth longitudinal study (georgs)

Conditions: Malocclusion; Dental Caries

Summary: the aim of the study is to follow a group of preschool children from early permanent dentition to determine the prevalence and incidence of caries malocclusions and to investigated the related risk factors as age, gender, ethnic origin and non-nutritive sucking habits, breathing disturbances, allergies, dietary habits, oral hygiene status and dental care.

once a year a clinical examination were performed. data were collected with a questionnaire, that was filled out by the parents before the clinical examination, which included questions on child's clinical history, the type of feeding, the use of baby-bottle, the history of non-nutritive sucking habits (dummy-sucking and digit sucking) and the consent to the clinical examination. two world health organization (who) calibrated examiners carried out the clinical examinations. they were blinded to the information collected from the parental questionnaires. dental examinations were performed in a classroom environment under natural light, using gloves and masks in compliance with the infection control protocol, mouth mirrors and disposable paper rulers to measure overjet and overbite (in millimeters). the occlusion was assessed in centric occlusion and was classified according to foster and hamilton criteria \[foster and hamilton, 1969\] radiographic examination was not performed.

Eligibility criteria:
inclusion criteria: * children born in 2008 and 2009 in chiavari district (italy) exclusion criteria: * parents' lack of consent * absence at the date of the visit; no compliance * orthodontic treatment; marked occlusal wear or early * loss of primary teeth * alterations in the number, size and shape of teeth * syndromes or systemic problems affecting craniofacial growth * cleft palate.